DIANA E PEREZ Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

INOPERATIVE

Business

First Name

DIANA

Middle

Last Name

PEREZ

Business Name

DIANA E PEREZ

Original Issue Date

02/22/2012

Effective Date

03/13/2018

Expiration Date

03/01/2020

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019